THE LATEST: New Medicare Policies For New York and New
Jersey
from
the March 2004 issue
Empire
Medicare, handling Medicare policies of New York and New
Jersey, has recently published their final policy, which will
go into effect April 4, 2004. The policy reads as follows:
TRAINING
REQUIREMENTS:
While
it is not the Carrier's intention or jurisdiction to credential
providers, Medicare does expect a satisfactory level of competence
from providers who submit claims for services rendered. It is
well known that substandard studies often lead to preventable
repetition of studies and overutilization of services.
The
acceptable levels of competence are outlined as follows:
For
the technical portion, an acceptable level of competence
is fulfilled when the image acquisition is obtained under any
one of the following conditions:
a.
The service is performed by a physician; or
b.
The service is performed by a technician who is credentialed
as either a Registered Diagnostic Cardiac Sonographer (RDCS)
through the American Registry of Diagnostic Medical Sonographers
or as a Registered Cardiac Sonographer (RCS) through the Cardiovascular
Credentialing International; or
c.
The service is performed at a laboratory (e.g., office, IDTF),
credentialed by the Intersocietal Commission for the Accreditation
of Echocardiography Laboratories (ICAEL).
For
the professional portion, an acceptable level of competence
is fulfilled when the interpretation is performed by a physician
meeting any one of the following requirements:
a.
The physician is board certified in Cardiovascular Diseases;
or
b.
The physician has Level II training in transthoracic echocardiography,
as defined by the American College of Cardiology/American
Heart Association/American College of Physicians Task Force
on Clinical Competence in Echocardiography, or the equivalent
of Level II training as set forth in that document; or
c.
The physician provides the interpretation in conjunction with
a study that is performed at a laboratory that is accredited
by the Intersocietal Commission for the Accreditation of Echocardiography
Laboratories and that is subject to such laboratory's quality
assurance policies and procedures; or
d.
The physician has staff privileges to interpret echocardiograms
at a hospital that participates in the Medicare program.
The
submission of claims for echocardiography will be considered
an attestation that both the technical and professional components
of the service were provided within the context of the above
stated credentials. However, a grace period of two years will
be allowed for providers to acquire the necessary training.
This
policy can be viewed in its entirety on the Empire
Medicare website.
|
